#Reduce Weight Reduction

[hitch-ride]

LIPOZEM Is the Natural Metabolism Boost You've Been Missing! REVIEW

[mortalislabs]

Trigonelline is a methylated form of niacin and is a recently isolated molecule that could be the secret ingredient in your stack. This form of the B vitamin is involved in the generation of NAD+, a cofactor for over 500 metabolic processes in cells. Trigonelline promotes cellular repair and energy, and as we’ll see, exerts quite a few benefits that are specifically useful for anyone training seriously.

Trigonelline is found in several plant-based foods, notably coffee beans and fenugreek seeds. Green coffee beans contain trigonelline concentrations ranging from 0.6% to 1.0% by weight. However, traditional dietary sources don’t provide sufficient amounts to elicit significant physiological effects. For instance, the average trigonelline content in a cup of coffee is approximately 53 mg, and about 50-80% of trigonelline decomposes during the roasting process, leaving virtually nothing for your body to make use of.

Recent research published on this naturally occurring alkaloid highlights its potential in enhancing muscle function and combating age-related decline. A 2024 study published in Nature Metabolism identified trigonelline as a novel precursor to nicotinamide adenine dinucleotide (NAD+), a molecule essential for energy metabolism and mitochondrial function. The study demonstrated that trigonelline supplementation improved muscle strength and reduced fatigue in aged mice, suggesting that it can head off the natural muscle decline seen in aging, even in those who are already training at capacity.

NAD+ gets discussed a lot in the longevity space because of its natural and steep decline over the years, tied to all the diseases of aging. It's a metabolic linchpin that determines how efficiently your cells convert fuel into usable energy. For athletes, that efficiency translates into faster recovery, better performance under load, and greater resilience under metabolic stress. Or, you know, complete lack of those things if you don’t have enough of it.

NAD+ is required for redox (oxidation–reduction) reactions in mitochondrial energy production and is a cofactor and substrate for longevity-promoting sirtuins and other enzymes involved in muscle repair and adaptation. During intense physical activity, NAD+ levels drop as demand for ATP surges. Replenishing intracellular NAD+ is critical not only for restoring mitochondrial output but also for initiating the cellular programs that rebuild and reinforce muscle tissue [1].

Trigonelline offers a direct path to NAD+—one that bypasses the liver and supports muscle tissue specifically. In a landmark 2024 study, researchers at EPFL and Nestlé Health Sciences (yes, that Nestlé, but there aren’t any conflicts of interest, we checked) demonstrated that trigonelline functions as a previously unidentified NAD+ precursor, rapidly taken up by skeletal muscle cells and converted into NAD+ via a salvage pathway independent of the traditional NR or NMN routes [2]. This muscle-specific uptake is particularly important for athletes, who require localized replenishment in the very tissues under stress.

Most NAD+ precursors—including nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN)—undergo hepatic metabolism before entering systemic circulation. This creates a bottleneck at your liver for targeted muscle repair. Trigonelline appears to bypass that constraint by delivering precursors directly where they're needed most: the muscle fibers responsible for performance and endurance.

This shift in delivery has implications beyond simple NAD+ restoration. In the same Nature Metabolism study, aged mice supplemented with trigonelline showed significant improvements in grip strength and fatigue resistance—outcomes tightly linked to muscle NAD+ availability. Unlike systemic precursors that may elevate circulating NAD+ levels without improving localized bioenergetics, trigonelline drives changes in muscle mitochondrial density and function.

For athletes, this is the difference between feeling recovered and actually being rebuilt.

Mitochondria Make Muscles Move

Endurance Starts in the Electron Transport Chain

Every sprint, every lift, every set depends on one thing: mitochondrial output. The ability to generate ATP on demand—efficiently and cleanly—is the defining line between sustained power and early fatigue. Trigonelline’s value lies not just in elevating NAD+ levels, but in what that elevation enables at the level of mitochondrial performance.

NAD+ drives oxidative phosphorylation, the mitochondrial pathway responsible for converting nutrients into ATP. When NAD+ is depleted, electron transport slows, reactive oxygen species accumulate, and mitochondrial output tanks—resulting in performance collapse and prolonged recovery. Replenishing NAD+ restores mitochondrial throughput, enhances metabolic flexibility, and allows cells to switch between carbohydrate and fat oxidation with minimal friction [3].

Trigonelline’s role as a direct NAD+ precursor in muscle tissue makes it especially powerful in this context. By bypassing hepatic metabolism and restoring NAD+ where it's most needed, it kickstarts mitochondrial biogenesis—activating pathways like PGC-1α that drive the formation of new mitochondria and increase the efficiency of existing ones [4]. This isn’t theoretical: in the 2024 Nature Metabolism study, trigonelline supplementation significantly boosted mitochondrial content and activity in aged mice, restoring performance metrics typically lost with age and overtraining [2].

This cellular shift translates directly to the field, the track, and the gym. More mitochondria means more ATP per unit of oxygen consumed. This is the underpinning of higher VO₂ max, improved lactate clearance, and extended time-to-exhaustion. Trigonelline supports this adaptation at the source, which means athletes can train harder, go longer, and bounce back faster—without relying on stimulants or sketchy ergogenics.

More NAD+ in muscle equals better mitochondrial kinetics, which equals better athletic output. Period.

Strength and Muscle Health

Preserving Power, Not Just Mass

Strength isn’t only about size—it’s about contractile quality, neuromuscular precision, and the cellular capacity to resist breakdown under stress. Trigonelline’s impact on muscle tissue reaches beyond endurance. It supports structural integrity, performance output, and resilience across multiple pathways—especially in the context of aging or chronic training demand.

In the 2024 Nature Metabolism study, trigonelline supplementation restored muscle grip strength and improved fatigue resistance in aged mice, with outcomes exceeding those observed in control groups receiving traditional NAD+ precursors [2]. This effect was tied to increased NAD+ availability in skeletal muscle, which reactivated SIRT1- and PGC-1α-dependent pathways responsible for mitochondrial biogenesis, inflammation control, and protein maintenance—all critical for contractile performance and mass preservation [5].

NAD+ also plays a protective role against muscle wasting. It regulates the balance between anabolic and catabolic signaling, modulating FoxO transcription factors and suppressing atrophy-related genes like MuRF1 and atrogin-1 [6]. This anti-catabolic signaling becomes especially important during periods of calorie deficit, illness, or overreaching, when muscle degradation accelerates. Trigonelline, by supplying NAD+ directly to muscle cells, may help maintain lean mass even under systemic stress.

One overlooked aspect of muscle performance is neuromuscular junction (NMJ) stability, or, the connections between nerves and muscle fibers. These connections go both ways, with afferent signals carrying sensory feedback from muscle to brain, and efferent signals delivering motor commands from brain to muscle. Maintaining the integrity of this bidirectional communication is essential for coordination, strength, and rapid recovery from fatigue. NAD+ is required for the function of enzymes that protect NMJ architecture—particularly in aging or disease models where synaptic decline contributes to strength loss [7]. Trigonelline’s direct muscle delivery may therefore preserve the electrical signaling fidelity needed for explosive power and motor unit recruitment.

Muscle Fiber Type Preservation

Emerging evidence suggests that NAD+ availability influences muscle fiber type composition. High NAD+ levels favor the maintenance of fast-twitch (Type II) fibers—those responsible for strength, speed, and power—by enhancing mitochondrial support without triggering full transition to slow-twitch oxidative profiles [8]. This has implications for athletes seeking to maintain peak force output without compromising endurance. By elevating muscle NAD+ directly, trigonelline may help preserve this delicate fiber balance.

Trigonelline is formulated not to just support general energy—but to protect the architecture of athleticism at the cellular level.

For a reliable, pure form of trigonelline with zero additives, you can trust Mortalis Labs.

[fatliberation]

Anti-Obesity Drugs in Sociopolitical Context

Abstract

This literature review critically examines the use of Body Mass Index (BMI) as a diagnostic tool for obesity, highlighting its historical and scientific flaws. The diagnosis and treatment of obesity is heavily stigmatized and reflects deeper socio-economic and racial biases. Fatphobia, or anti-fatness, is deeply rooted in white supremacy and colonial history. I argue that anti-fatness and weight-based discrimination significantly impact health outcomes, rather than body fat percentage alone. The way that the medical system focuses on body size rather than the overall health of patients perpetuates harm and yields even poorer health outcomes. To genuinely improve the lives of fat individuals, we must dismantle anti-fat systems and remove barriers to healthcare, job equity, and basic infrastructure by implementing legal protections, rather than simply promoting weight loss. This review emphasizes the need for a holistic approach to health that considers socio-economic factors and systemic discrimination.

Journal Summary

Recently, two anti-obesity medications, Ozempic and Wegovy, which are primarily prescribed for type 2 diabetes mellitus (T2DM), have shown promise in causing weight loss. The 2022 scientific journal “Ozempic and Wegovy for Weight Loss, Pharmacological Component and Effect” by Abdullah Mohammed, et al explores the pharmacological components and effects of these medications on weight reduction, summarizing findings from existing clinical studies.

Ozempic is a glucagon-like peptide-1 (GLP-1) receptor agonist primarily used to manage T2DM. Clinical studies indicate that semaglutide can also promote significant weight loss. Ozempic's mechanism involves binding to GLP-1 receptors in the brain, reducing food intake and increasing feelings of fullness. This leads to a decrease in body weight and improvement in glycemic control. Wegovy, also a GLP-1 receptor agonist, is the same drug as Ozempic but two times the dose, specifically approved for weight loss for fat people even without T2DM. Administered as a weekly injection, Wegovy has shown effectiveness in inducing sustained weight loss. The STEP trials demonstrated that participants using Wegovy experienced an average weight loss of 15.8% over 68 weeks. Wegovy's pharmacokinetics involve prolonged activation of GLP-1 receptors, enhancing satiety and reducing hunger. GLP-1 receptor agonists like semaglutide mimic the action of the natural hormone GLP-1, which regulates appetite and blood sugar levels. By slowing gastric emptying and promoting a feeling of fullness, these medications reduce caloric intake. Clinical trials have shown that GLP-1RAs, including semaglutide, can result in weight loss from 5% or up to 10-15% of body weight. However, sustained weight loss requires ongoing lifestyle modifications, as discontinuation of the medication leads to weight regain. Common side effects of GLP-1 receptor agonists include gastrointestinal issues such as nausea, vomiting, diarrhea, and constipation. Other potential side effects include increased heart rate, fatigue, headaches, and changes in thyroid function.

Obesity as a Disease

How does one get an obesity diagnosis? There is one single criterion used for diagnosing someone with this disease: The Body Mass Index (BMI). A person’s BMI is their weight in kilograms divided by the square of their height in meters, rounded to one decimal place. It does not account for muscle mass versus body fat. For these reasons, the BMI has been widely proven to be an ineffective health measure. The BMI was also never intended to be a measure of health in the first place.

The BMI was created in the 1800s by a statistician named Adolphe Quetelet, who did not study medicine, to gather statistics of the average height and weight of specifically white, European, upper-middle-class men to assist the government in allocating resources. It was never intended as a measure of individual body fat, build, or health (Karasu, 2016). Quetelet is also credited with founding the field of anthropometry, including the racist pseudoscience of phrenology. Quetelet’s L’homme Moyen would be used as a measurement of fitness to inspire, and as a scientific justification, for eugenics (Eugenics archive).

Studies have observed that about 30% of "normal” weight people are “unhealthy," whereas about 50% of "overweight" people are “healthy” (Rey-López, et al, 2014). Thus, using the BMI as an indicator of health misclassifies 75 million people in the United States alone. “Healthy*” lifestyle habits are associated with a significant decrease in mortality regardless of baseline body mass index (Matheson, et al, 2012).

*I put “healthy” in quotation marks here because the definition of an individual’s health is oversimplified and depends on many socioeconomic factors.

While epidemiologists use BMI to calculate national obesity rates, the distinctions between weight classes can be arbitrary. Ever notice that the weight classes on the BMI are nearly intervals of five? In 1998, the National Institutes of Health lowered the overweight threshold from 27.8 to 25—making roughly 29 million Americans "overweight" overnight—to match international guidelines (Butler, 2014). Critics have also noted that those guidelines were drafted in part by the International Obesity Task Force, whose two principal funders were companies making weight loss drugs.

Jackie Scully, Senior Research Fellow at the Unit for Ethics in the Biosciences, University of Basel, in her scientific journal titled “What is a Disease?” states the following: “As the business literature shows, new clinical diagnoses are often welcomed primarily as opportunities for market growth (Moynihan et al, 2002). One recent example of this is female sexual dysfunction (FSD). The huge commercial success of sildenafil (Viagra) for erectile dysfunction in men provides a strong motivation for drug companies to identify an equivalent market (that is, condition) in women. And some ethicists feel that drug companies were, to put it mildly, over-involved in the medical consensus meetings held between 1997 and 1999 that effectively drew up very inclusive clinical criteria for the definition of FSD (Moynihan, 2003)."

How can one diagnose a person with a disease and sell them medications solely based upon an outdated measure that was never meant to indicate health in the first place, especially when obesity has no proven causative role in the onset of any chronic condition? (Kahn, et. al., 2000), (Cofield, et al, 2010).

This is why the term “obese” is recognized as a slur by fat communities. It's a stigmatizing term that medicalizes fat bodies even in the absence of disease. The word directly translates to "having eaten oneself fat" in Latin. Obesity, as a medical diagnosis, doesn’t have much ground to stand on. Aside from being overtly incorrect as a medical tool, the BMI is used to deny certain medical treatments and gender-affirming care, as well as insurance coverage. Employers still often offer bonuses to workers who lower their BMI. Although science recognizes the BMI as deeply flawed, it's going to be tough to get rid of. It has been a long-standing and effective tool for the oppression of fat people and the profit of the weight loss industry.

To treat obesity, patients must eat less. Making someone smaller still means they will be healthier, right?

Fatness and Mortality

The idea that obesity is unhealthy and can cause or exacerbate illnesses is a biased misrepresentation of the scientific literature that is informed more by bigotry than credible science (Medvedyuk, et al, 2017). Fatphobia existed long before fatness became medicalized. Yes, obesity is correlated with conditions such as cardiovascular disease, hypertension, and diabetes, but some scientists are looking into possibilities that don't equate correlation with causation. Obesity has no proven causative role in the onset of any chronic condition (Kahn, et al, 2000), (Cofield, et al, 2010) and its appearance may be a protective response to the onset of numerous chronic conditions generated from currently unknown causes (Lavie, et al, 2009), (Uretsky et al, 2007), (Mullen, et al, 2013), (Tseng, 2013). A portion of these correlated conditions are likely brought on by the stress of being part of one or more marginalized groups with little to no support or basic access in society. Weight stigma itself is deadly. Research shows that weight-based discrimination increases risk of death by 60% (Sutin, et al, 2014).

Dieting also poses serious health risks. The reason that these weight loss drugs are so successful by comparison is that dieting is unsustainable and does not lead to prolonged weight loss. Over 50 years of research conclusively demonstrates that virtually everyone who intentionally loses weight by manipulating their eating and exercise habits will regain the weight they lost within 3-5 years, and 75% will regain more weight than they lost (Mann, et al, 2007). Evidence suggests that repeatedly losing and gaining weight is linked to cardiovascular disease, stroke, diabetes, and altered immune function (Tomiyama, et al, 2017). If most fat people have historically tried to lose weight their whole lives through dieting, this has major implications on overall health. Prescribed weight loss is also the leading predictor of eating disorders (Patton, et al, 1999).

Another factor that may be impacting fat people’s rate of mortality is that they are being mistreated at the doctor’s office. I have personally heard dozens of stories about doctors refusing to treat or investigate a problem that a fat person came in for until they lost a certain amount of weight, only to discover years later that the problem was unrelated to their weight and has progressed severely because it went untreated. Fat people are often mistreated and looked at with disgust and disdain in medical settings, leading them to avoid going to the doctor in shame or fear of abuse. This can seriously worsen health issues. Fat stigma in the medical establishment (Puhl, et al, 2012) and society at large arguably (Engber, 2009) kills more fat people than fat does (Teachman, et al, 2003), (Chastain, et al, 2009), (Sutin, et al, 2015). This impact is too significant not to be taken under consideration.

Anti-Fatness as Anti-Blackness

The issue of anti-fat bias is directly rooted in white supremacy. The ideal thin body was constructed as a marker of whiteness and “purity” before any of this was ever made to be about health. Dr. Sabrina Strings has spent her career studying this history. In her book, Fearing the Black Body: The Racial Origins of Fat Phobia, Dr. Strings discusses how constructions of race led to the thin ideal. “Over the decades, the rise in biracial children would break down the way that slave owners saw Blackness and whiteness. To combat the hypocrisy they created, owners invented new ways to dehumanize the enslaved population. They made a calculated decision to start putting more value on white physiques versus Black ones. In her research, Strings found that Black women’s bodies were otherized even more than Black males. For colonizers who hadn’t seen diverse body types before, they quickly categorized the Black female figure as ‘deviant,’ ‘greedy,’ and ‘overtly sexual.’ The fact that we still use these terms to describe fat bodies today is all the evidence we need to understand that fatphobia is directly linked to racism, not health. This mindset was also strengthened by Protestantism. Slave owners looked for any way to prove their power over the enslaved people, and they frequently used religion as ‘proof’ of their racist superiority. Additionally, Protestant belief encouraged various ways to become closer to God, which included eating as little as possible. This would resonate the most with white women. They had as much to do with perpetuating fatphobia as their husbands. White women were desperate to show their own power against Black women on the plantation, and the difference between their bodies was the perfect rift. And so began the centuries-old belief that thinness is beautiful, and fatness is ugly” (Sassenrath, 2023).

Revisiting the Journal with Context

Thinness has been an important value throughout history in the United States. Our positive associations with thinness and negative associations with fatness have led to a collective schema that is black and white, good versus bad, beautiful versus ugly, healthy versus unhealthy, and life versus death. This has led the FDA to approve Wegovy as a weight loss drug with haste, after just sixteen months of testing. It is known that going off the drug will result in rapid weight regain, so patients are expected to be on it for the rest of their lives when there have been no long-term studies. We do not yet know if the drug will have long-term effects, yet it has been approved for kids as young as twelve (FDA, 2021). As of July 2024, Novo Nordisk has a market cap of $633.01 billion (Marketcap). 

Wegovy is prescribed along with diet and exercise, which has been proven to lead to weight regain and eating disorders. Patients are being prescribed Wegovy and Ozempic when they are fat, but otherwise metabolically healthy. If this drug is truly a game changer for public health, we should be measuring how patients' health improves over the long-term rather than how much weight they lose. For example, if these drugs improve heart health, they should be prescribed as a heart health medication for patients with heart disease, rather than prescribed as a weight loss fix based on body size alone. With the evidence we have, we know it is possible to be fat and healthy, so these drugs may be solely cosmetic in many cases.

Future

If we want to improve the lives of fat people, we will remove barriers to care, not try as hard as we can to make all fat people disappear. That will never happen. If we truly cared about the well-being of fat people and not their disappearance, we would work to dismantle the systems that oppress them and abolish anti-fatness. 

Currently, fat people have next to no legal protections for being discriminated against (NAAFA, 2023). Fat people are denied housing, (Kariss, 1977) jobs, and receive less pay and promotions legally because of their size (The Economist). They are denied access to clothing, seating, transportation, and other human rights because infrastructure has been designed to exclude them. Fat people have less likelihood of receiving a fair trial (Beely, 2013), and are denied necessary surgeries (Barrett, 2022) ––but not weight loss surgery that amputates the digestive tract. Fat people are denied gender-affirming care (Conley, 2023), in vitro fertilization and reproductive healthcare (Muir, 2024), even adopting children (Carter, 2009). Fat children have been removed from their loving parents because when their diets failed, it was seen as neglect (Badshah, 2021). Fat people have disproportionately high suicide rates (Wagner, et al, 2013), and are facing medical malpractice and mistreatment (Kolata, 2016).

Can a drug fix that?

References

Karasu, Sylvia. Adolphe Quetelet and the Evolution of Body Mass Index (BMI). Psychology Today. https://www.psychologytoday.com/us/blog/the-gravity-of-weight/201603/adolphe-quetelet-and-the-evolution-of-body-mass-index-bmi 2016, March 8.

“Quetelet, Adolphe.” Eugenics Archive, www.eugenicsarchive.ca/connections? id=5233cb0f5c2ec5000000009c. Accessed 5 July 2024.

Rey-López JP, de Rezende LF, Pastor-Valero M, Tess BH. The prevalence of metabolically healthy obesity: a systematic review and critical evaluation of the definitions used. ObesRev.2014 Oct;15(10):781-90. doi: 10.1111/obr.12198. Epub 2014 Jul 16. PMID: 25040597.

Matheson EM, King DE, Everett CJ. Healthy lifestyle habits and mortality in overweight and obese individuals. J Am Board Fam Med. 2012 Jan-Feb;25(1):9-15. doi: 10.3122/jabfm.2012.01.110164. PMID: 22218619.

Butler, Kiera. “Why BMI Is a Big Fat Scam.” Mother Jones, 25 Aug. 2014, www.motherjones.com/politics/2014/08/why-bmi-big-fat-scam/.

Kahn BB, Flier JS. Obesity and insulin resistance. J Clin Invest. 2000 Aug;106(4):473-81. doi: 10.1172/JCI10842. PMID: 10953022; PMCID: PMC380258.

Cofield SS, Corona RV, Allison DB. Use of causal language in observational studies of obesity and nutrition. Obes Facts. 2010 Dec;3(6):353-6. doi: 10.1159/000322940. Epub 2010 Dec 10. PMID: 21196788; PMCID: PMC3280017.

Medvedyuk, S., Ali, A., & Raphael, D. (2017). Ideology, obesity and the social determinants of health: a critical analysis of the obesity and health relationship. Critical Public Health, 28(5), 573–585. https://doi.org/10.1080/09581596.2017.1356910

Kahn BB, Flier JS. Obesity and insulin resistance. J Clin Invest. 2000 Aug;106(4):473-81. doi: 10.1172/JCI10842. PMID: 10953022; PMCID: PMC380258.

Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol. 2009 May 26;53(21):1925-32. doi: 10.1016/ j.jacc.2008.12.068. PMID: 19460605.

Uretsky S, Messerli FH, Bangalore S, Champion A, Cooper-Dehoff RM, Zhou Q, Pepine CJ. Obesity paradox in patients with hypertension and coronary artery disease. Am J Med. 2007 Oct;120(10):863-70. doi: 10.1016/j.amjmed.2007.05.011. PMID: 17904457.

Mullen JT, Moorman DW, Davenport DL. The obesity paradox: body mass index and outcomes in patients undergoing nonbariatric general surgery. Ann Surg. 2009 Jul;250(1):166-72. doi: 10.1097/SLA.0b013e3181ad8935. PMID: 19561456.

Tseng CH. Obesity paradox: differential effects on cancer and noncancer mortality in patients with type 2 diabetes mellitus. Atherosclerosis. 2013 Jan;226(1):186-92. doi: 10.1016/ j.atherosclerosis.2012.09.004. Epub 2012 Sep 21. PMID: 23040832.

Sutin, A. R., Stephan, Y., & Terracciano, A. (2015). Weight Discrimination and Risk of Mortality. Psychological Science, 26(11), 1803-1811. https://doi.org/10.1177/0956797615601103

Tomiyama, A Janet, et al. “Long‐term Effects of Dieting: Is Weight Loss Related to Health. Socialand Personality Psychology Compass, 6 July 2017, escholarship.org/uc/item/0tv27311.

Mann T, Tomiyama AJ, Westling E, Lew AM, Samuels B, Chatman J. Medicare's search for effective obesity treatments: diets are not the answer. Am Psychol. 2007 Apr;62(3):220-33. doi: 10.1037/0003-066X.62.3.220. PMID: 17469900.

Patton GC, Selzer R, Coffey C, Carlin JB, Wolfe R. Onset of adolescent eating disorders: population based cohort study over 3 years. BMJ. 1999 Mar 20;318(7186):765-8. doi: 10.1136/bmj.318.7186.765. PMID: 10082698; PMCID: PMC27789.

Puhl, Rebecca, and Kelly D. Bronwell. “Bias, Discrimination, and Obesity.” Obesity Research, 6 Sept. 2012. doi.org/10.1038/oby.2001.108

Engber, Daniel. “Glutton Intolerance: What If a War on Obesity Only Makes the Problem Worse?” Slate, https://slate.com/technology/2009/10/the-health-effects-of-discrimination-against-fat-people.html 5 Oct. 2009.

Teachman, B. A., Gapinski, K. D., Brownell, K. D., Rawlins, M., & Jeyaram, S. (2003). Demonstrations of implicit anti-fat bias: The impact of providing causal information and evoking empathy. Health Psychology, 22(1), 68–78.

Chastain, Ragen. “So My Doctor Tried to Kill Me.” Dances With Fat, https://danceswithfat.org/2009/12/15/so-my-doctor-tried-to-kill-me/ 15 Dec. 2009.

Sutin AR, Stephan Y, Terracciano A. Weight Discrimination and Risk of Mortality. Psychol Sci. 2015 Nov;26(11):1803-11. doi: 10.1177/0956797615601103. Epub 2015 Sep 29. PMID: 26420442; PMCID: PMC4636946.

Sassenrath, Jenna. “Anti-Blackness Is Anti-Fatness in ‘Fearing the Black Body.’” Bookstr, bookstr.com/article/anti-blackness-is-anti-fatness-in-fearing-the-black-body/ 26 July 2023.

“Novo Nordisk (NVO) - Market Capitalization.” CompaniesMarketCap.Com - Companies Ranked by Market Capitalization, companiesmarketcap.com/novo-nordisk/marketcap/ 2024.

Commissioner, Office of the. “FDA Approves New Drug Treatment for Chronic Weight Management, First since 2014.” U.S. Food and Drug Administration, FDA, www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014. 5 July 2024.

Karris, L. (1977). Prejudice against Obese Renters. The Journal of Social Psychology, 101(1), 159–160. https://doi.org/10.1080/00224545.1977.9924002

“Campaign for Size Freedom.” NAAFA, 2023,

naafa.org/sizefreedom. 5 July 2024.

“The Obesity Pay Gap Is Worse than Previously Thought.” The Economist, The Economist Newspaper, www.economist.com/finance-and-economics/2023/11/23/the-obesity-pay-gap-is-worse-than-previously-thought. 5 July 2024.

Elizabeth Beety, Valena (2013) "Criminality and Corpulence: Weight Bias in the Courtroom," Seattle Journal for Social Justice: Vol. 11: Iss. 2, Article 4. https:// digitalcommons.law.seattleu.edu/sjsj/vol11/iss2/4

Berrett, Martyn. “More Obesity Discrimination: The NHS Will Deny Non-Urgent Surgery to Obese Patients.” Healthier Weight, 24 Nov. 2022, www.healthierweight.co.uk/blog/more-obesity-discrimination-the-nhs-will-deny-non-urgent-surgery-to-obese-patients/.

LaRosa, John. “U.S. Weight Loss Industry Grows to $90 Billion, Fueled by Obesity Drugs Demand.” Market Research Blog, The Freedonia Group, Inc., 2 May 2024, blog.marketresearch.com/u.s.-weight-loss-industry-grows-to-90-billion-fueled-by-obesity-drugs-demand.

Conley, H. “Studies Show Top Surgery Is Safe for FAT Patients, but Some Surgeons Still Mandate Weight Loss.” STAT, 25 July 2023, www.statnews.com/2023/06/02/top-surgery-safe-fat-patients/.

Muir, Becca. “Opinion: Women with Obesity Are Often Restricted from IVF. That’s Discriminatory.” NPR, 14 Jan. 2024, www.npr.org/sections/health-shots/2024/01/14/1224546666/opinion-women-with-obesity-are-often-restricted-from-ivf-thats-discriminatory.

Carter, Helen. “Too Fat to Adopt - the Married, Teetotal Couple Rejected by Council Because of Man’s Weight.” The Guardian, Guardian News and Media, 13 Jan. 2009, www.theguardian.com/society/2009/jan/13/adoption-rejected-couple.

Badshah, Nadeem. “Two Teenagers Placed in Foster Care after Weight Loss Plan Fails.” The Guardian, Guardian News and Media, 11 Mar. 2021, amp.theguardian.com/society/2021/mar/10/two-teenagers-placed-in-foster-care-after-weight-loss-plan-fails.

Wagner B, Klinitzke G, Brähler E, Kersting A. Extreme obesity is associated with suicidal behavior and suicide attempts in adults: results of a population-based representativesample. Depress Anxiety. 2013 Oct;30(10):975-81. doi: 10.1002/da.22105. Epub 2013 Apr 10. PMID:23576272.

Kolata, Gina. “Why Do Obese Patients Get Worse Care? Many Doctors Don’t See Past the Fat.” The New York Times, The New York Times, 26 Sept. 2016, www.nytimes.com/2016/09/26/health/obese-patients-health-care.html.

[videolari]

ISTANBUL OBESİTY CENTER

Welcome to the Istanbul Obesity Center, where transformative weight loss solutions meet world-class medical expertise. As obesity continues to be a growing concern across the globe, our center is dedicated to providing patients with effective and safe surgical options, tailored to individual needs. Whether you’re exploring gastric sleeve surgery, gastric balloon placement, or gastric bypass surgery, our skilled team in Turkey is here to guide you through every step of the process.

Gastric Sleeve Surgery in Turkey

Opting for gastric sleeve surgery in Turkey can be a transformative choice for individuals seeking effective weight loss solutions. This minimally invasive procedure involves removing a significant portion of the stomach, allowing patients to feel fuller quicker and consume fewer calories. With highly trained medical professionals and state-of-the-art facilities, Turkey has emerged as a premier destination for this type of surgery.

One of the key benefits of undergoing gastric sleeve surgery in Turkey is the affordability without compromising quality. The cost of the procedure is significantly lower than in many Western countries, allowing more patients to access this life-changing surgery. Moreover, many clinics offer comprehensive packages that include accommodation, pre-operative assessments, and post-operative care, enhancing the overall experience.

Patient reviews consistently highlight the exceptional care received during their weight loss journey in Turkey. From the initial consultations to the post-operative follow-ups, the emphasis is placed on patient comfort and outcomes, which has contributed to high satisfaction rates. This reinforces the credibility of Turkey as a leading destination for gastric sleeve surgery.

If you are considering gastric sleeve surgery, now is the perfect time to take the first step toward a healthier and happier life. Explore your options and see how this life-changing procedure can make a difference in your life today!

Gastric Balloon in İstanbul

For those seeking an effective and less invasive option for weight loss, the gastric balloon in Istanbul offers an excellent solution. This non-surgical procedure involves the temporary placement of a silicone balloon in the stomach, which helps to significantly reduce hunger pangs and promote a feeling of fullness. As a result, patients can effectively control their food intake and achieve their weight loss goals.

The gastric balloon is designed to remain in place for six months, during which time individuals often experience substantial weight reduction. Many patients report losing 15 to 30 kilograms, giving them the confidence to lead healthier lifestyles. This procedure is ideal for individuals who may not be ready for more permanent solutions like gastric sleeve surgery in Turkey or gastric bypass surgery in Turkey.

Another important aspect of the gastric balloon procedure in Istanbul is its flexibility. Patients can opt for an outpatient experience, allowing for a quick recovery and minimal disruption to their daily lives. The Istanbul Obesity Center is known for its comprehensive aftercare, ensuring that patients receive the support they need throughout their weight loss journey.

With positive weight loss surgery Turkey reviews highlighting the success and satisfaction rates, the gastric balloon has become a popular choice among those looking to kickstart their journey towards better health. If you've been considering options for weight loss, the gastric balloon in Istanbul might be the perfect step for you.

Gastric Bypass Surgery Turkey

Choosing gastric bypass surgery in Turkey can significantly change your life for the better. This advanced surgical procedure is designed to ensure effective weight loss for those who have struggled with obesity. At the Istanbul Obesity Center, we focus on providing state-of-the-art treatments combined with exceptional care, ensuring our patients have the best possible experience and outcomes.

Key Benefits of Gastric Bypass Surgery

Effective Weight Loss: Gastric bypass effectively reduces the size of your stomach and alters the digestive process, leading to substantial weight-loss results.

Improved Health Conditions: Many patients experience a reduction in obesity-related health issues, such as diabetes, hypertension, and sleep apnea.

Enhanced Quality of Life: Beyond physical benefits, patients often report improved mental health and overall life satisfaction after surgery.

Success Stories

We have countless testimonials from satisfied patients who have transformed their lives through gastric bypass surgery in Turkey. These real-life success stories showcase not only the physical changes but also the newfound confidence and active lifestyles our patients have embraced post-surgery.

If you're considering gastric bypass surgery, take the first step towards a healthier and happier life by contacting us today. Our team at the Istanbul Obesity Center is ready to assist you on your journey to weight loss and improved well-being!

Weight Loss Surgery Turkey Reviews

When considering weight loss surgery Turkey reviews play a crucial role in understanding the quality of care and the outcomes experienced by others. Many individuals who have opted for gastric sleeve surgery in Turkey, gastric balloon in Istanbul, or gastric bypass surgery in Turkey have shared their positive transformations, contributing to a growing pool of success stories.

Patients frequently highlight the professionalism and expertise of healthcare providers at Istanbul Obesity Center. From the initial consultation through the surgical procedure and post-operative care, they rave about the support and guidance received, making their journey smoother and more reassuring.

Moreover, several reviews emphasize the transformation not just in weight but also in lifestyle and confidence levels post-surgery. Many individuals report achieving their desired weight goals, leading to improved physical health and overall well-being.

For those contemplating these procedures, reading testimonials and reviews can provide valuable insights. Clients often recommend reaching out for consultations to discuss their personal goals and objectives, ensuring that weight loss surgery aligns perfectly with their expectations.

[scientia-rex]

I made that post about how smoking is bad—actually, no, I’ve made two relatively popular posts about how smoking is bad for you. Raises your chances of dying from multiple factors including heart disease and stroke in addition to lung (and mouth, throat, and bladder) cancer.

I am always so baffled by the responses going “well I could die from something else!” Yes. You could. Statistically speaking, you will most likely die of heart disease, stroke, or cancer, if you live in the US. Your average life expectancy is somewhere around 78 for women, 76 for men. Many people die younger than that, for a lot of reasons. Many of my patients have illnesses that will shorten their lives. I hate to split it into “fault,” as if there’s some kind of perfect way to live a blameless life. (There isn’t.) The numbers, however, are both clear and pitiless. People who smoke are more likely to die younger than they otherwise might have.

Medicine is a numbers game. My job is not to psychically predict exactly what will punch your ticket and when. It is to improve your odds. I want you to both live as long a life as possible but also as high-quality a life as possible. I want for you to live a life you enjoy.

It’s that simple; it’s not sinister. I’m not out here going “I’ll tell them not to smoke so they can have LESS FUN before getting hit by a bus at 30!”

Because smoking isn’t actually fun. What it is, is a very quick (and faster = more addictive) reduction in physical feedback systems that heighten anxiety. Withdrawal of an unpleasant stimulus is rewarding. (Technically, it’s a negative reward; the negative doesn’t refer to a moral judgment, but the addition or subtraction of a stimulus.) Something that is very rewarding very fast will be very addictive. It’s why crack cocaine is also so addictive—it is also a very fast and very potent reward. It’s also why benzodiazepines like Xanax are so addictive to so many people; it’s a slower peak blood level but the removal of severe anxiety is profoundly rewarding.

So smoking can make you feel better when you do it. But your body will try to fix any broken signals. It doesn’t just want to be able to signal to you when you need to feel stressed: it has to be able to signal you, or your long-ago ancestors would have been eaten by predators. So it ramps up the signaling. Now you’re not smoking because you feel better than baseline; you’re smoking to get back to baseline.

That’s why quitting sucks. When you quit smoking, all of the sudden your body’s signals of stress that got dialed up to 11 to overcome the nicotine are just out there at full blast, making you feel scared and jittery and irritable. It’s why when you quit benzos (or daily alcohol) cold turkey you can get life-threatening seizures. It’s why when you stop alcohol you’re likely to have sleep disruptions that can persist for weeks to months.

That’s why things that help reduce the suckage can help. Nicotine patches, lozenges, or gum. Chantix. Wellbutrin. Slowly stepping down the nicotine level on your vape. Eating more, eating things you like. (I would 1000% rather have a patient be fat than be smoking. I know other people will be shittier to you if you gain weight. Living is worth it.) Being kind to yourself helps you quit smoking. You need to recognize that “quitting smoking you” is not your baseline you. It is you with an invisible illness that will take weeks to months to get over.

And sometimes you can’t face that hump right now. But if you want to maximize your odds of the longest and healthiest possible life, knowing that any number of terrible things can happen to you at any time, making the effort—over and over again, if you need to—is the best shot you have.

There are a couple of conditions where smoking does markedly reduce symptoms. The well-known ones are schizophrenia and Crohn’s disease. If you feel not just better, but better like this is a medication for you, like you poop blood or hear things without it, talk to your primary care provider, because there are other medicines that might be safer and/or more effective for you. The landscape around pharmaceutical research has shifted dramatically over the last 30 years. We have more options than we’ve ever had before. Maybe this doesn’t have to be the expensive, dangerous medication that half-works for you. And if what you’re self-medicating is your anxiety, nicotine is a pretty crappy medication for that, because it doesn’t fix you; it changes your baseline to an even shittier place.

You have bodily autonomy. You can make your own choices. I will never go to a patient’s house and slap the cigarette out of their hand. But if what you want is the longest and healthiest possible life, smoking makes your odds worse.

The number of people who think that I, as a doctor, would be unaware of how profoundly unfair bodily health can be amazes me. It’s like the first Father Brown story, where Father Brown is explaining to the villain that someone whose main job is to hear about all of the terrible sins people have to confess cannot remain naive. My job is watching people age, or filling out their death certificates. One or the other. I prefer watching them age, but everyone will die. Someday my doctor will be filling out my death certificate. I’ve removed one potential contributing factor from that line—maybe I’ll get diabetes, maybe I’ll get cancer, maybe I’ll have a workplace accident, but “smoking” isn’t going to be on that line anymore. That’s the best I can do. I can’t psychically predict my own death, either; just play the numbers, try to do my best, and hope.

[reasonsforhope]

"A first-of-its-kind report has discovered that altering the ingredients list or manufacturing methods of widely used medication can really cut back on carbon emissions.

They found a reduction of 26 million tons, enough to cancel out the whole carbon footprint of the city of Geneva for a decade. Best of all, it’s already happening, and in fact, is almost done—those emissions were already saved.

The lifesaving HIV treatment dolutegravir (DTG) is used by 24 million people worldwide.

Today, over 110 low and middle-income countries have adopted DTG as the preferred treatment option. Rapid voluntary licensing of the medicine, including its pediatric version, to over a dozen generic manufacturers, significantly drove down prices, and it’s estimated that 1.1 million lives will be saved from HIV/AIDS-related deaths by 2027.

Its predecessor, efavirenz, contained 1200 milligrams of active ingredient across the three active compounds present, while DTG contains 650 milligrams of just one compound. This small difference—literally measurable in single digits of paper clips by weight—was enough to change the carbon emissions footprint of the medication by a factor of 2.6.

The incredible discovery was made in a recent report by Unitaid, a global public-private partnership that invests in new health products and solutions for low and middle-income countries, called Milligrams to Megatons, and is the first published research to compare carbon footprints between commonly used medications.

“This magnitude of carbon footprint reduction surpasses many hard-won achievements of climate mitigation in health and other sectors,” the authors of the report write.

At the rate at which DTG is produced, since it entered into production and treatment regime in 2017, 2.6 million fewer tons of CO2 have entered the atmosphere every year than if efavirenz was still the standard treatment option.

Health Policy Watch reports that the global medical sector’s carbon emissions stand at roughly 5% of the global carbon emissions and are larger than the emissions of many big countries, and 2.5 times as much as aviation.

“This report demonstrates that we can achieve significant health improvements while also making strides in reducing carbon emissions. By adopting innovative practices and prioritizing sustainability, we can ensure that medicines like DTG are not only effective but also environmentally responsible,” Vincent Bretin, Director of Unitaid’s Results and Climate Team told Health Policy Watch."

-via Good News Network, July 17, 2024

[genderoutlaws]

just wanna put it out there clearly that i am very much pro decriminalization and pro focusing on harm reduction and education over shame and punishment. even in a quote unquote perfect world addiction would still exist but it is exacerbated by the crushing weight of capitalism, cisheteropatriarchy, white supremacy, imperialism. and the so called united states relies on the continued existence of dependency issues and the abjection of the people with those issues, so that they can be used as cheap/slave labor in our prison system. but decrim and harm reduction services has been shown time and again to reduce overdose, reduce rates of contracting HIV and hep C, and increase the amount of ppl entering treatment programs. but it also decreases incarceration rates so this evil occupying body would never allow it

[lilu787788]

Aleksander is, without a doubt, one of the most misunderstood characters in modern pop culture. And what’s worse, that misunderstanding often comes directly from the people who claim to support or “analyze” him. Too many limit themselves to surface-level narratives, repeating shallow takes without even attempting to engage with the complexity the show gives him. They don’t want to think about what it means to lead in a world built on fear, war, and survival. They want heroes and villains. They want moral simplicity. Aleksander offers none of that, so they either label him the villain or turn him into a fantasy object. Both of these approaches miss the reality of who he is.

Let’s be clear. He is not some romantic lead who got a little corrupted. Nor is he a power-obsessed monster. He is a man who had no choice but to lead, to survive, to make strategic decisions in a world that has always treated his people as disposable. Aleksander is not choosing between good and evil. He is choosing between bad and worse. And he knows it. That’s the difference. He is not naive. He is not driven by idealism. He acts with full awareness that every path he chooses comes with consequences, often including loss of life. That is leadership in a broken system. That is war. But instead of acknowledging that weight, fandom reduces him to a flat symbol.

This is the same fandom that cheers on so-called morally grey characters in other universes, or even in this one. And no, Crows are not morally grey. They are morally safe. But when it comes to Aleksander, that flexibility vanishes. Why? Because he doesn’t offer easy moral commentary. He doesn’t beg for forgiveness. He doesn’t give long dramatic speeches to justify himself. He expects people to think, to grasp context, and to understand what responsibility really looks like. And apparently, that’s too much effort for many.

Then there is the constant reduction of his story to his relationship with Alina. It happens repeatedly, even among fans who claim to care about him and wave the books around like they prove something. They treat him like a side character in her arc. They forget that Darklina exists because of him. But he is not defined by that ship. He has his own motivations, his own trauma, his own legacy. Stripping him of all that and reducing him to a romantic checkpoint is just as shallow as calling him a simple villain.

Worse are the tired, unserious arguments like “he’s thousands of years old” as if that somehow erases his pain, his goals, or his humanity. Yes, today one antis lady who read the books and understands them wrote to me that he is thousands of years old... The show never gives him a godlike or cosmic status. Yes, he is old. Yes, he carries history. But he is not immortal in the way people claim. What we see, thanks to Ben’s performance, is a man who has endured. A man whose age is written in exhaustion, not invincibility. He is tired, and that shows. But he keeps fighting. Even when children scream at him that they know better.

And then there is fanfiction, which more often than not turns him into a sexual caricature. An obsessive, manipulative seducer who thinks of nothing else. This version is just as far removed from canon as the villain stereotype. If you write him like that, you do not understand him. You are not building on the story. You are replacing it with a shallow imitation. And if you do that, you should not be preaching about who is or isn’t interpreting him correctly.

The truth is Aleksander represents difficult choices. He shows uncomfortable truths about power, survival, and control. People don’t like that, so they rewrite him into something easier to hate or easier to digest. But his story was never designed to make you feel good. It was meant to challenge you.

Ben gave us a version of Aleksander that is nuanced, vulnerable, and precise. A version that carries the weight of centuries and still chooses to fight. He is not perfect. He never claimed to be. He doesn’t have to be perfect to matter. He just needs to be understood in context. And if you’re not willing to do that work, maybe you shouldn’t be shaping the discourse around him at all?

[fearfulfertility]

PATERNITY WARD WEEKLY BULLETIN

This week’s activity report from Paternity Compound 145 highlights a continued shift from group-based programming to individualized physical relief, reflecting declining surrogate interest in structured recreation.

Despite concentrated efforts by staff, most surrogates reportedly prefer private gratification routines. As such, the DRC plans to phase out morale programming in favor of stimulation-based care.

BINGO – BACK BY POPULAR DEMAND!

Join us in Recreation Room 4 for weekly Bingo!

Winners will receive a bonus hour of physical gratification with a pre-selected member of staff.

(Reminder: Yelling "bingo!" without a win will result in revocation of stretchmark cream for 2 days.)

PAINTING – BUILD A BELLY

Join us in Recreation Room 3 for "build-a-belly!" Surrogates can decorate their bellies with stickers, glitter, and paint.

(Reminder: Surrogates will be hosed down after, no paint or other containments allowed in medical wards.)

MEDICAL REMINDERS

If your oxygen intake monitor is blinking red, alert a nurse.

Daily blood draw compliance is mandatory. Missed draws will result in reduced recreation time.

Any unauthorized birth outside designated delivery areas will be classified as "Disruptive Expulsion" and non-reportage will result in disciplinary action for entire ward.

CLEANLINESS IS COMPLIANCE!

A friendly reminder from Sanitation Officer [REDACTED]:

Do not attempt to detach your nipple cups during daily milking. If suction is not turned off, this could result in injury or spilt milk. Infractions will result in delay in daily milking sessions.

Stay hooked up. Stay safe.

MAINTENCE BULLETINS

Communal Showers 3 through 6 will be closed today for maintenance, due to structural damage.

Surrogates are cautioned not to engage in sexual gratification with their peers in the shower area. Further, surrogates are reminded that shower heads and pipes are not designed to handle excessive weight, do not hang or lean on them.

NOTICE: UNAUTHORIZED GAMES

The following activities are not approved for recreation:

"Guess the Fetal Count" (Causes emotional distress)

“How Far Can I Lean Forward” (Causes premature labor)

“Suck The Belly Button?” (Inappropriate)

Participation in banned games will result in personal gratification privileges removal.

THIS WEEK’S BIRTH RECORDSS

Surrogate S145-193P: Gave birth to sexdecuplets (16) over 32 hours of labor

Surrogate S145-117R: Gave birth to octodecuplets (18) after only 5 hours of labor

REMEMBER:

"The swelling is not a burden. It is the sound of a nation growing. You are full. You are vital. You are needed." ~ DRC Central Command

------------------------------------------------------------------------------

ADDENDUM – RECREATIONAL ATTENDANCE

DRC, Facility Operations Command, Compound Oversight Unit

Date: [REDACTED]

Subject: Reduction in Recreative Participation

To: Director [REDACTED]

While all activities listed above remain officially voluntary, attendance is increasingly mandatory as engagement metrics continue to drop. Compliance Officers have noted that most surrogates, after the first week of gestation, show little interest in group activities and prefer private stimulation behaviors. While this aligns with the expected rise in prenatal nymphomania all surrogates experience, it is also a waste of resources for our morale officers to pan.

Beginning next cycle, we will be deprecating the morale department and transferring all personnel to activities that support self-gratification activities for surrogates.

REQUESTED SUPPORT MATERIALS

1. Personal Relief Devices

Handheld or bedside-mounted vibration devices designed to help surrogates manage spermic pressure, stimulation urges, and muscular restlessness.

2. Lubricant Gel – Medical Grade

Non-scented lubrication gel, safe for internal and external use, compatible with most materials. Aids in reducing irritation during frequent intercourse.

3. Visual Distraction Content

DRC-approved pornographic videos designed to stimulate emotional arousal. Filmed encounters from other paternity compounds would be ideal.

4. Rotational Operator Contact

For surrogates physically unable to complete relief routines unaided, trained Physical Comfort Technicians should be rotated in to assist with physical gratification. Each session should not exceed one hour unless medically necessary.

----------------

Click Here to return to DRC Report Archives

[fatliberation]

I totally understand and can empathize with fat activists when it comes to medical fatphobia. But I do think its important to provide nuance to this topic.

A lot of doctors mention weight loss, particularly for elective surgeries, because it makes the recovery process easier (Particularly with keeping sutures in place) and anesthetic safer.

I feel like its still important to mention those things when advocating for fat folks. Safety is important.

What you're talking about is actually a different topic altogether - the previous ask was not about preparing for surgery, it was about dieting being the only treatment option for anon's chronic pain, which was exacerbating their ed symptoms. Diets have been proven over and over again to be unsustainable (and are the leading predictor of eating disorders). So yeah, I felt that it was an inappropriate prescription informed more by bias than actual data.

(And side note: This study on chronic pain and obesity concluded that weight change was not associated with changes of pain intensity.)

If you want to discuss the risk factor for surgery, sure, I think that's an important thing to know - however, most fat people already know this and are informed by their doctors and surgeons of what the risks are beforehand, so I'm not really concerned about people being uninformed about it.

I'm a fat liberation activist, and what I'm concerned about is bias. I'm concerned that there are so many BMI cutoffs in essential surgeries for fat patients, when weight loss is hardly feasible, that creates a barrier to care that disproportionately affects marginalized people with intersecting identities.

It's also important to know that we have very little data around the outcomes of surgery for fat folks that isn't bariatric weight loss surgery.

A new systematic review by researchers in Sydney, Australia, published in the journal Clinical Obesity, suggests that weight loss diets before elective surgery are ineffective in reducing postoperative complications.

CADTH Health Technology Review Body Mass Index as a Measure of Obesity and Cut-Off for Surgical Eligibility made a similar conclusion:

Most studies either found discrepancies between BMI and other measurements or concluded that there was insufficient evidence to support BMI cut-offs for surgical eligibility. The sources explicitly reporting ethical issues related to the use of BMI as a measure of obesity or cut-off for surgical eligibility described concerns around stigma, bias (particularly for racialized peoples), and the potential to create or exacerbate disparities in health care access.

Nicholas Giori MD, PhD Professor of Orthopedic Surgery at Stanford University, a respected leader in TKA and THA shared his thoughts in Elective Surgery in Adult Patients with Excess Weight: Can Preoperative Dietary Interventions Improve Surgical Outcomes? A Systematic Review:

“Obesity is not reversible for most patients. Outpatient weight reduction programs average only 8% body weight loss [1, 10, 29]. Eight percent of patients denied surgery for high BMI eventually reach the BMI cutoff and have total joint arthroplasty [28]. Without a reliable pathway for weight loss, we shouldn’t categorically withhold an operation that improves pain and function for patients in all BMI classes [3, 14, 16] to avoid a risk that is comparable to other risks we routinely accept.

It is not clear that weight reduction prior to surgery reduces risk. Most studies on this topic involve dramatic weight loss from bariatric surgery and have had mixed results [13, 19, 21, 22, 24, 27]. Moderate non-surgical weight loss has thus-far not been shown to affect risk [12]. Though hard BMI cutoffs are well-intended, currently-used BMI cutoffs nearly have the effect of arbitrarily rationing care without medical justification. This is because BMI does not strongly predict complications. It is troubling that the effects are actually not arbitrary, but disproportionately affect minorities, women and patients in low socioeconomic classes. I believe that the decision to proceed with surgery should be based on traditional shared-decision making between the patient and surgeon. Different patients and different surgeons have different tolerances to risk and reward. Giving patients and surgeons freedom to determine the balance that is right for them is, in my opinion, the right way to proceed.”

I agree with Dr. Giori on this. And I absolutely do not judge anyone who chooses to lose weight prior to a surgery. It's upsetting that it is the only option right now for things like safe anesthesia. Unfortunately, patients with a history of disordered eating (which is a significant percentage of fat people!) are left out of the conversation. There is certainly risk involved in either option and it sucks. I am always open to nuanced discussion, and the one thing I remain firm in is that weight loss is not the answer long-term. We should be looking for other solutions in treating fat patients and studying how to make surgery safer. A lot of this could be solved with more comprehensive training and new medical developments instead of continuously trying to make fat people less fat.

[railfangxy]

The Embodiment of Streamline Moderne

Most steam streamliners have shrouds to bring the engine into a Moderne style. Be that styling the engine to look as new as its consist does on the inside, OR embracing a look that borrows from contemporary diesel power.

Seems the Pennsylvania Railroad T1's were the exact opposite, at least at first. A futuristic design concept by Raymond Loewy was adapted to fit the outline of a steam engine

Just look between these two and the resemblance is clear

The T1's are already fairly modern machines as far as steam locomotives go. True, they are reciprocating machines so they still use cylinders and rods compared to individual steam motors, or a steam turbine drive. However, there's two or three aspects about them to complement their forward styling.

First is the duplex drive. The concept was to create a locomotive that was easier on the track at higher speeds by splitting up the driving wheels. More cylinders are needed, but the actual reciprocating mass is reduced. The T1's weren't the first iterations of this, on or off their home railroad, but they came with something else.

Second is poppet valves; more familiar with stationary steam engines, and persist today in internal combustion engines. Compared to piston valves, poppets allow for more precise timing of admission and exhaust to the cylinder, thus more power can be obtained. Poppet valves were tried a few times in the US in the 20s, and saw use elsewhere, but almost nothing like what the T1's had

Lastly is the Franklin System of Steam Distribution. This is a form of valve gear, large based on Lentz gear as it uses oscillation cams and has valves positions more like a piston. However, there's multiple sets of these valves, and the actual reciporicating mass is miniaturized and housed in a gearbox casing. In addition to the slight power boost offered by poppet valves, this further reduction of weight means the engine puts less energy into moving itself compared to its train. In addition, this protected the motion and meant maintenance requirements were actually lower compared to conventional valve gear.

If you know anything about the T1 that last part may sound odd, but the first engine to use the Franklin system did indeed require less maintenance than others in its division. The streamlining made access tricky, but it was really a problem when it came to making repairs not general maintenance.

All this and more set the T1 apart from anything that came before, or really since. It's only fitting they look the part of being a vision of the future. Just had no idea where the styling originated for them to look so much more modern on the outside, when they were already steps forward on the inside.

The best part about the iconic profile is that it never really left. I don't just mean the later T1's or the similar looking diesels. The prototype T1's kept the Loewy influence up front right til the end. Just iconic

[phinena]

Introducing my H2O DR

No one ever talks about H2O or mermaid DRs on here, at least no one I know of, so I will

H2O DR (have yet to shift here)

PSA before I start: if you have problems with race-changing or aging down/up, I am not the creator for you. I do what I want, and I don’t care. I change what I look like and my age for any and every DR.

𝐆𝐄𝐍𝐄𝐑𝐀𝐋 𝐈𝐍𝐅𝐎𝐑𝐌𝐀𝐓𝐈𝐎𝐍

𝐍𝐀𝐌𝐄⋮ Lilith Mayama Allaire

𝐀𝐆𝐄⋮ 15

𝐁𝐈𝐑𝐓𝐇𝐏𝐋𝐀𝐂𝐄⋮ Sydney Australia

𝐂𝐔𝐑𝐑𝐄𝐍𝐓 𝐋𝐎𝐂𝐀𝐓𝐈𝐎𝐍⋮ Clear Water Islands, Australia. (Near Gold Coast)

𝐏𝐑𝐎𝐍𝐎𝐔𝐍𝐒⋮ She/her

𝐅𝐀𝐌𝐈𝐋𝐘⋮ Céline Allaire (mother), Xavier Allaire (Father), Rhysand Allaire(19), Serona Allaire (12), Adelio Allaire (10)

𝐏𝐄𝐓𝐒⋮ Zena-female dog (5 years old), Zax-male dog (3 years old), Sadie-female dog (4 months old), Alure- female white fox (2 years old)

𝐇𝐄𝐈𝐆𝐇𝐓⋮ 5’7

𝐖𝐄𝐈𝐆𝐇𝐓⋮138 lbs

𝐄𝐘𝐄 𝐂𝐎𝐋𝐎𝐑: Ocean Blue

𝐇𝐀𝐈𝐑 𝐂𝐎𝐋𝐎𝐑: Red (used to be dark brown. The red hair is only on my head, and maybe tints my eyebrows. Since I pretty much script I don’t hair in unwanted places.)

𝐅𝐀𝐂𝐄 𝐂𝐋𝐀𝐈𝐌(𝐒)⋮ A mix between these. Mostly have the looks of the girl on the left, but the eye color, hair/hair color, and skin tone of the girl on the right

And then when I’m older I look like this, but with blue eyes and red hair

𝐁𝐀𝐂𝐊𝐆𝐑𝐎𝐔𝐍𝐃⋮ I was born in Sydney, Australia, lived there until 6 years old, before moving to Gold Coast. My parents are loving and never problematic, my siblings are the same way. I am crazy about Volleyball and love it. My favorite positions are Right Back and Opposite/Outside hitter. I got into volleyball as a young child in Sydney. I got on travel teams and did them a lot. My mother is fashion designer for medium sized brand in Australia. My dad is an architect and is a the CEO of his company that builds a diverse amount of skyscrapers. My family is very close and friendly, my siblings and I barely fight. Etc etc

𝐏𝐎𝐖𝐄𝐑𝐒/𝐀𝐁𝐈𝐋𝐈𝐓𝐈𝐄𝐒⋮

this is about to be long, so I will shorten this up as best as possible

Atmokinesis: (main power) to control weather

Hydrokinesis- control liquid

Aerokinesis- control air

Hydro-Cryokinesis- freeze liquids

Cryokinesis- freeze anything even without the presence of liquid

Gelidkinesis- turn water into a jellylike texture

Substanciakinesis- power to turn water or liquids into a substance similar to crystal or glass, rendering it nearly indestructible

Hydro-Thermokinesis- the ability to heat any liquid or objects

Pyrokinesis- the ability to start and stop fire

Electrokinesis- the ability to create lightning bolts or electricity

Invisibility- the ability to turn invisible for any amount of time

Invisibility detection- the power to detect invisible objects or beings

Volume reduction-the ability to reduce the volume of an object or thing

Zoolingualism- the ability to understand and talk to all animals (more like an understanding of how they are feeling, but can understand like they’re speaking a languge)

Essence manipulation- the ability to manipulate essence to make a being feel calm and not scared or worried

Telekinesis- the ability to move objects with mental power. (Specifically I can’t move anything that is 100x my weight)

Telepathy- the ability to communicate through the mind. Specifically with other magical/mythical creatures.

Speed swimming- when activated, the user can swim 10-100mph, they can choose how much faster by thinking of going faster

Precognition- user can see up to 24 hours in the future if an important life changing effect is to occur

Siren voice- the ability to hypnotize any man with a special voice

Enhanced Senses- basically what it’s called. All senses: touch, smell, hear, taste, and see, are enhanced naturally. Although you can enhance them more by focusing on one sense at a time. Along with enhanced senses, are enhanced emotions as well.

Healing- the ability to heal wounds. Minor wounds are easier to heal than major. Cannot bring anything back from the dead

Special powers

Gyrokinesis- Gravity manipulation would allow one to increase or decrease gravity, be it the gravity of the environment or individual objects

Mnemokinesis- User can control memories of oneself and others, allowing them to modify, fabricate, suppress, influence, repair, restore, erase, detect, and view them. They can change memories to confuse, wipe away certain memories to cause amnesia, discern and provoke nostalgia, and enter the victim into a psychic vision, replaying their memories

Technokinesis- The user possesses complete control over all technology and devices and can create and manipulate technology, the sum of techniques, skills, methods, and processes used in the production of goods or services or in the accomplishment of objectives.

Did I discover all these powers at once. No. My weather control was the first I discovered. The rest came to me over a 2-3 year discovery. I was the only one, so it took a hot minute. My special powers came to me last.

𝐓𝐀𝐈𝐋⋮ so imagine the red color pattern on the right, but on the design of the tail on the left. (Not my design)

𝐑𝐄𝐃 𝐌𝐄𝐑𝐌𝐀𝐈𝐃𝐒⋮ Red mermaids are born or turned in a moon pool on a Lunar eclipse. (I know what the show says, I’m turning it into a solar eclipse. Plus they didn’t even show a lunar eclipse). They are usually easily identifiable by their red hair and red tail. If a human falls into a moon pool on a lunar eclipse, their hair will turn fully red within 24 hours. Specifically the hair on their head. A baby mermaid born under a lunar eclipse in a moon pool, will also have this. The moon must be red at the time of being over the moon pool(s). If it’s not red, then it’s just a regular full moon. The water will mimic the redness of the moon during the bubbling process.

HOWEVER, a red mermaid cannot be created from an existing mermaid. A human who’s already transformed into a mermaid cannot come back under a lunar eclipse and gain the red mermaid abilities. Nor any regular mermaid. They must be born in or magically turned during the blood moon.

Red mermaids are known to be stronger than regular full moon mermaids. They swim faster, their powers are stronger, and they even transform 15 seconds after touching water instead of ten. Red mermaid’s powers are as powerful as 80 moons, making them stronger than the moon rings. Though they can decide the strength of their power with practice.

𝐇𝐎𝐖 𝐈 𝐁𝐄𝐂𝐀𝐌𝐄 𝐀 𝐌𝐄𝐑𝐌𝐀𝐈𝐃⋮ My family went camping on Mako, unknowing of the Lunar eclipse. Again I changed the Lunar eclipse to a solar eclipse. Plus that’s what they showed in H2O anyway. Well during the time my family was asleep, I needed to use the bathroom. I was such a curious child, with a good sense of direction, I decided to do some midnight exploring. I was walking around and seeing all these trees and what not. Then I heard the waterfall, that’s what drew me in. I thought it was so cool, so I climbed the waterfall. I was looking up at the moon seeing it start to change color, which was my mistake because I misstepped and fell down the cave hole. I knew it was going to be impossible for me to climb back up so I looked around. There was moonlight coming from the mako cave entrance and so I went there. Weird me brought my goggles that had those nose covering with me. I knew my only chance was to swim.

So when the time came for me to jump in, I looked up, saw the volcano and the moon above me. And quickly felt the water start to bubble. I didn’t even know what was happening. And then the moon’s color made the water turn red, it was surreal. I stayed in the pool for a bit before deciding to head out. The bubbling was still going on. It only took me a minute to swim out of the cave and to the surface, and thanks to those goggles, I was able to hold my breath that long. However, swimming in dark water, NOT RECOMMENDED. Hello that was scary for me as a child. Anyway, I came out on the east side of the so I knew I had to go west. Water was freezing btw.

I came back to my campsite maybe two hours later, soaking wet. Cold asf. Changed and went back to sleep. Now the next morning, did my parents wonder why my clothes were hanging up to dry, yes. I just lied and said I fell into the water we were sleeping near. No, I was not going to tell my parents about the adventure i went on, because I knew they would be mad I went off alone. I have no idea how they didn’t smell the ocean on me.

We went home that day, and I took a nap on the way. When we arrived back home, I had umm noticed something in the mirror. A couple strands of my hair turned dark red, I didn’t even know how that happened. So I went to my room and tried washing it out. Nope. Bad idea. Suddenly I felt my body tingle so badly, my legs went numb that collapsed on the floor. My clothes disappeared and were replaced by a red tail and red scales covering my upper body.

And that’s how I became a mermaid.

𝐇𝐎𝐖 𝐈 𝐌𝐄𝐓 𝐓𝐇𝐄 𝐆𝐈𝐑𝐋𝐒⋮

It’s during episode 18. Bad Moon Rising. I wanted to meet the girls later into the season. I’m going to make this quick. I would say the girl and I are school acquaintances. I know of them, but don’t hang out with them, as I have my own friend group.

I have been seeing the girls act up around water in school for a while. And then I heard them talking about the full moon and mako. So I had a sneaking suspicion. I tested it out in Chem by using my powers to spill water onto Cleo, don’t worry she was able to get out of the room and to a safe spot on time. I took a wild guess and assumed they were mermaids.

After school, I was in my stalker era and decided to follow Cleo, Emma, and Rikki, to Emma’s house. I staked, then went home cause I got hungry asf, and the moon wouldn’t rise for a couple of hours anyway. So when I came back, for the night, I saw Lewis camping outside. I stayed far back so he couldn’t see me. Effectually Rikki went under the moon spell, and ran out of the house. I followed her to mako. Then simply trailed her as she went through the Mako forests.

Zane still makes an appearance, and the whole kiss still happens. I put out the fires except for the main ones around her. I focus on controlling them and making sure they don’t go out of control.

Anyway the girls show up in the morning and I decided to appear. They were kinda shocked to see me, but they were too worried about Rikki and Zane. I just lied and said I was camping with my family and smelled smoke and wanted to come check it out.

While they weren’t looking, I turned myself invisible, which they were confused at where I went, but just went back to Rikki and Zane. When they left for mako, I trailed them. At the end where Rikki finally snaps out of it, I pop out of the shadows. They were surprised and worried. But before they could freak out, I assured them, I couldn’t reveal their secret. I jumped in the water, revealing I was a mermaid as well, and the rest is history….

⤕⤕⤕⤕⤕⤕⤕⤕⤕⤕⤕⤕⤕⤕⤕⤕⤕⤕⤕⤕⤕

And there we go. Introduction over. Let me know if yall want me to keep posting about this DR.

And now some pictures that represents this DR

[grandwitchbird]

I talked about this already to some extent. But let’s round it up. Because there’s new DA people and I’m v tired but also invested at this point.

Also there’s a broader point here. Several tbh.

When people are kind of flailing around looking for the source of problems with a piece of media, particularly an unchallenging piece of media, and resorting to a shallow set of ‘criticisms’ that gesture at real issues, often there are fundamental flaws in said piece of media. They’re just being misidentified to the point of nonsense.

When something is by all metrics genuinely well done AND spectacular in execution, you do not get this. You get straightforwardly stupid people crying about Atreus acting like a child. You get transparently bigoted or immature people whining about Ellie or Joel having coherent arcs.

When something is by most metrics competently written but lacking in execution in multiple ways AND it makes ‘representation’ a selling point. It’s gonna get both column 1 and column 2 in force. This makes everything very loud and very stupid forever. I refuse to be held captive by that so I will keep talking about real things. Because in column 1 there’s an attempt to get at the actual problems, just without the needed vocabulary and experience.

And yes there’s overlap in column 1 & 2. I call it the clown show. That’s just not everything that’s happening.

The actual problems in Veilguard are the problems with BioWare as a whole. And mostly they have to do with motivation and ethics. Anyone who wants to seriously understand what’s gone so terribly wrong with every game release since Origins needs to reckon with this.

This company refuses to consistently define its storytelling values within the game world/s beyond ‘yay friendship’ and ‘trauma sad’. This is why the use of sexual violence in origins is there to shock 12 year olds. If that game were well written and actually meant for mature adults, sexual violence would just be one bad thing that can happen* to people (and if it were weighted towards women, we’d have clearly defined patriarchal systems and sexism that, again, is not there for laughs or shock value) and there would be some actual grasp of psychology and power in the text in general. This is also why people are reducing an attempt at actual mythic storytelling with Mythal to ‘abusive mother’ ‘trauma sad’. These games as texts invite reduction.

That psychology? Utterly lacking for the most part. And not lacking in the way of a story that’s doing something else. Lacking because the text willfully uses shorthand and assumed empathy** from the audience instead of laying bare the actual human motivations*** behind everything. Individual characters rise above this, and all the characters give hints of it, but that’s not the same as actually writing a story that accounts for real human motivations as part of its larger narrative. Characters in truly robust fiction are supportive functions of the larger narrative, and that narrative has clear priorities founded on strong values.****

The damn audience. These games are written for a specific audience. And that audience is really racist and pretty self indulgent. It doesn’t care about motivation. It thinks Varric is an interesting character who isn’t written like a checklist. It’s happy as long as it gets to smash its dolls together. It also likes to send death threats. This audience is an abstracted boogeyman in the writers room as far as I can tell, and it’s stealing all the motivation.

Cannot believe this site has pushed me to actually say this. It’s liberal! These are distinctly liberal games. They cannot and will not say anything truly meaningful because their whole ethos is built on pretending they’re not conservative (an ethos defined by retreat). This is why the subversion of power fantasy in DA is interesting but can ring hollow. It’s incoherent for a reason! It’s not looking its values in the eye. This is also why ME2 remains distinct. Turns out it’s easier for liberals to write villains pretending to be heroes. Take that as you will.

I’m not really interested in talking about how corny Bioware dialogue has always been. It’s always been corny. There’s actual voice direction problems in Veilguard that add a layer of technical problems to this, and that’s a bit more interesting, if frustrating to experience. This is why people are reaching for when they say ‘clunky’. I’m also not really interested in the structural issues. Which are there. Because there’s fewer structural issues in Veilguard than in any previous BioWare game. Most of these complaints are coming from people who have apparently let time soften them on how poorly built the other games are. Again. These are real problems people are flailing at with reductive takes. They’re also on brand for BioWare.

So that whole mess up there? That’s what’s going on. It’s what’s going on with the games and the actual real life audience constantly being at each others throats. It’s what’s going on with expectations and weird takes and the usual clown show.

* You can also go the Alien route of course. But this would require the violence to happen indiscriminately re: gender, and it would need to use the disgust response intelligently to interrogate something like…oh I don’t know the disgusting male power fantasy intrinsic to forced pregnancy-as horror.

** This is part of why people keep saying ‘marvel’. Marvel movies run on assumed empathy and it’s the most immediate touchstone and cheapest shot. BioWare was doing it first though. Guardians is literally riffing on DA and ME. And yes it’s cheap writing. I just don’t know why anyone expects anything else.

*** I’d be fine with mythic or purely dramatic motivations myself, but these games definitely do not know how to do more than gesture at that.

**** Something that’s gotten seriously muddled in our current publishing environment. Character-driven doesn’t mean you can reduce everything to the characters and their arcs. This is how we get shallow self-actualization narratives in place of deep explorations of what it means to be human. This is the problem at the heart of the ‘representation’ debates.

[cerastes]

can i get other examples of gamepress being wrong about arknights? i've been using them as my main source since i started and now i'm worried i'm missing out on some operators i haven't bothered to upgrade 🙃

We could be here literally all day because it's not like they have one or two outliers, Gamepress is just mainly edited by people that live in an echo chamber and that have authority in their own circle so it's just off-the-hip, all too often wrong biased takes based on their own really reductive metrics. Chiefly, Gamepress ranks characters 1) as if they were the sole unit in the battlefield almost exclusively, and 2) using the single most broken units currently live as the barrier of entry. The unit you are looking up can't clear a chunk of map in one tap? Worthless and sub-optimal, according to Gamepress. Their only metric is Mlynar, Ch'ung the Hung, Surtr, that kind of Press To Win philosophy, and if a unit can't do that, Then It's Bad And Not Worth It.

Now, you may be thinking, "goodness me, Dreamer, you are being awfully harsh to call them complete dogshit at every angle of the game in this manner!", well, see, it's not just their Operator "reviews", they have articles sometimes. And they are god awful dogshit as well, such as "What Happened To Blaze?"

You can't see the comments anymore, but the author was getting reamed. I have one screenie at least:

Comments were mainly of this nature. Because, well, the article is straight up awful, especially since it reduces Blaze to "laneholder" and compares her to "competition" like Thorns, Mudrock, and Mountain, who, yes, they all can hold a lane, but Blaze has her own space of "infinite duration, high statline, healable 3-block with 2 tile range" that has historically allowed for Funny Tricks like clearing enemies through "walls" on tiles that could shred Thorns even with a healer, or, you know, in conjunction with any of Mudrock or Mountain, given you have 12 whole slots for you team. Again, Gamepress editors rate characters as if they were your main in a fighting game and not one of 12+1 characters you can throw in at any time. They also tend to shit on non-specialist characters (generalists; more versatile units that can do a bunch of things without really breaking the game in any regard), which is very interesting because those usually will make up a strong backbone of any competent Integrated Strategies team, so the specialists in role can do their thing while the other needs of the map are being met.

"Ebenholz is nothing special." "Goldenglow is nothing special." These are takes they genuinely held until, you know, it turned out that Eben and GG are the most relevant Casters, up there with Eyja. To be fair, it wasn't just them being wrong on Eben, but how do you look at the global blasting of GG with her numbers and don't immediately realize that's an ICBM button? All it takes is having the game installed.

The biased nature of Gamepress is also blatant:

Imagine rating April as "Really Good" while relegating Dorothy as only "Really Fun". Even before her Module3, Dorothy was absolutely devastating, bringing huge damage multipliers, crowd control, one of the single best class autoattacks in the whole game at 6* stat weight, and a Talent that gives her even more Attack for basically using her as intended. I'm not saying April isn't good, mind you, I'm just trying to highlight how biased the hands behind Gamepress are: They can't figure out Trapmasters? Then surely they are merely "really fun". Can't drop and forget them like April or Surtr, after all.

About the only thing Gamepress is good for is objective, in-game info: Dates, mat requirements, what skills do, that kind of stuff. It's got a good interface and is a good place to just quickly look up what you need to know that can otherwise be found in the game. The moment their personal opinions come into play, though? The most absolute dogshit takes. Unless you are a "unga bunga drop Surtr and Mlynar and win instan-- WAIT WHY IS INTEGRATED STRATEGIES AND RISK 23+ KICKING MY DAY 1 PLAYER ASS...!?" kinda player, then you don't really want to follow Gamepress advice.

Because they simply do not give good advice as a whole.

[dhddmods]

Sex Alteration Guide (Bottom Surgery, Top Surgery, & Beyond!)

Hello! Just wanted to share our compiled list of sex alterations that can be performed. Thought it might be interesting for people who want to know.

If you want to learn about intersex types, we recommend reading our post here! And reblog it, please, to share awareness on intersex topics!

Trigger warning for mentions of genital mutilations on children, sexual activity, and sexual assault.

***********

Tracheal Shave: A procedure to shave down an Adam's Apple. This is done for aesthetic/personal reasons, or chosen by transfeminine, non-binary, altersex, or intersex people that were unhappy with their Adam's Apple.

Feminizing Laryngyoplasty: A procedure to shave the voice box, reducing the size of the Adam's Apple and increasing the pitch of the voice. This is chosen by transfeminine, non-binary, altersex, or intersex people that were unhappy with their voice, and elected for a permanent change instead of vocal practice.

Breast Lift/Mastopexy: A procedure to lift sagging breasts. This is done for aesthetic/personal reasons by people that were unhappy with their breasts.

Breast Augmentation: A procedure to (re)create breasts or reshape/increase the size of breasts, using implants or fat transplants from the thigh, buttocks, or abdomen. This is either done after a breast has been damaged/removed, for people with amastia or tubular breasts, or for aesthetic personal reasons by people that were unhappy with their breasts. It may also be chosen by transfeminine, non-binary, altersex, or intersex people that were unhappy with their chest. It can also be done to create extra breasts if desired.

Breast Reduction: A procedure to reduce the size of a breast. This is done for aesthetic/personal reasons, due to injury/damage, or to reduce the weight of large breasts. It may also be chosen by cis-men with gynecomastia, and transmasculine, non-binary, altersex, or intersex people that were unhappy with their breasts.

Mastectomy: A procedure to remove a breast. This is done for aesthetic/personal reasons, due to injury/damage, or chosen by people with accessory breasts that wish to have the spare breasts removed. It may also be chosen by cis-men with gynecomastia, and transmasculine, non-binary, altersex, or intersex people that were unhappy with their breasts.

Areola Reduction: A procedure to reduce the size of the areola. This is done for aesthetic/personal reasons by people that were unhappy with their areola size. It could be reduction of the size they were born with/developed during puberty, a reduction after pregnancy and/or breastfeeding caused nipple stretching, or it could be done to someone who had nipple (re)construction and were unhappy with the size the surgeon created.

Nipple Reduction: A procedure to reduce the size of a nipple. This is done for aesthetic/personal reasons by people that were unhappy with their nipple size. It could be a reduction of the size they were born with, a reduction after long-term breastfeeding caused nipple stretching, or it could be done to someone who had nipple (re)construction and was unhappy with the size the surgeon created.

Nipple Excision: A procedure to remove a nipple. This is done for aesthetic/personal reasons, due to injury/damage, or chosen by people with accessory nipples that wish to have the spare nipples removed. It may also chosen by transgender, altersex, or intersex people that were unhappy with their nipples.

Nipple (Re)construction: A procedure to create or recreate a nipple, using the skin from the chest, abdomen, inner thigh, buttocks, or (if present) previously existing nipples. This is either done after a nipple has been damaged/removed, for people born with athelia, or for those unhappy with inverted nipples. It can also be done to create extra nipples for aesthetic/personal reasons, or for non-binary or altersex people that wished for their body to have a specific appearance. When created from scratch, tattoos can be given for pigmentation of the nipple.

Vastectomy: A procedure to snip the vas deferens, in order to prevent the release of sperm (or eggs, in some cases of ovotestes.) This is done as a form of birth control, and can sometimes be reversible.

Tubal Ligation: A procedure to tie or snip the fallopian tubes, in order to prevent eggs from being fertilized (or sperm from being released, in some cases of ovotestes.) This is done as a form of birth control, and can sometimes be reversible.

Salpingectomy: A procedure to remove a fallopian tube. This could be done due to injury/damage or as a form of birth control.

Orchiopexy: A procedure done to move an undescended testicle into the scrotum. It is done on intersex people as a way to prevent testicular cancer, preserve fertility, and/or prevent inguinal hernias. It is one of the few intersex surgeries that are acceptable to do on infants.

Gonadectomy: A procedure done to remove a gonad (ovary, teste, or ovoteste.) When done to an ovary, it is known as an Oophorectomy. When done to a testicle, it is known as an Orchiectomy. This is done due to injury/damage or as a form of birth control. It may also be chosen by transgender, altersex, or intersex people that were unhappy with their gonads.

Hysterectomy: A procedure to remove the uterus. This could be done due to injury/damage, as a form of birth control, to stop painful menstruation, or to stop a uterus prolapse. It may also be chosen by transmasculine, non-binary, altersex, or intersex people that have no desire for a uterus, or have a uterus incompatible with pregnancy.

Trachelectomy: A procedure to remove a cervix. This is done due to injury/damage, a deformed cervix, to remove a hypoplastic cervix that does not release menstruation efficiently, or to remove a second cervix in cervical duplication.

Cervical (Re)construction: A procedure to create or recreate a cervix. This is either done after a cervix has been damaged, or for intersex people with cervical agenesis or cervical hypoplasia (to prevent menstrual fluids from getting trapped inside and/or to allow for easier pregnancy.)

Hysteroplasty/Uteroplasty/Metroplasty: A procedure done to those with a bicornuate uterus, septate uterus, or uterus didelphys to merge both sides/remove any blockage between them. This is done to lower risk of miscarriage and premature birth.

Prostatectomy: A procedure done to remove the prostate. This is done due to injury/damage.

Penis Splitting: A procedure done to split the penis (or ambiguous genitalia that has a penis-like structure) open. It could be done for aesthetic/personal reasons, for additional sexual enjoyment, or to assist with urination in those with a shallow, blocked, or absent urethra. It may also be chosen by trans-women & non-binary, altersex, or intersex people that were unhappy with their penis.

It is also explored as a cultural practice in some Australian, Africa, South American, and Oceanic locations.

Meatotomy: When only the urethral area of the glans is split open.

Subincision: When only the underside of the penis is split open, but the top-side is left closed. This split can give the penis a labia-like appearance, and allow for easier time with sex toys that do urethral penetration. This could be only on the glans or down to the shaft.

Genital Bisection: When the penis is split open completely. This could be only on the glans or down to the shaft.

Perineal Urethrostomy: A procedure done to open a urethra beneath the penis, on the perineum. It could be done for aesthetic/personal reasons or to assist with urination in those with a shallow, blocked, or absent urethra. It may also be chosen by transfeminine, non-binary, altersex, or intersex people that were unhappy with the placement of their urethra.

Urethroplasty: A procedure to create or repair a urethra. This could be done due to injury/damage, because of urethral blockage or an tight urethra, chosen by those with metoidioplasties/phalloplasties or vulvoplasities, or chosen by intersex people with urethral traits. For intersex people with urethral agenesis, it is necessary for urination.

Circumcision: A procedure to remove the foreskin. This could be done for aesthetic/personal reasons, due to injury/damage, or to assist with urination and hygiene if urine was consistently trapped in the foreskin. It is also done as a cultural practice in several African and Oceanic cultures, as well as a religious practice for Jews, Muslims, some Christians/Catholics, and a couple smaller Abrahamic religions.

Dorsal Slits: A procedure to remove a piece of the foreskin, leaving a slit on the upperside of the penis that exposes the urethra on the glans. This could be done for aesthetic/personal reasons or to assist with urination and hygiene if urine was consistently trapped in the foreskin. It is also explored as a cultural practice by some Filipinos and Pacific Islanders. A Ventril Slit is the same, but on the bottomside of the penis.

Prepuitioplasty: A procedure similar to a dorsal slit, except the top of the foreskin isn't cut, and after the slit is removed, the foreskin is sewn back together. It is done to make the foreskin looser, to treat those with phimosis (foreskin that will not retract).

Hoodectomy: A procedure to remove part or all of the clitoral hood, or to reduce its size. This could be done for aesthetic/personal reasons (for example, someone with a long clitoral hood may choose to reduce its size) or due to injury/damage. It may also be done as a form of circumcision or dorsal slits for transmasculine, non-binary, altersex, or intersex people who wish to indulge in those practices.

Labiaplasty: A procedure to remove, reduce, or create labia (usually the labia minora, but this could apply to the labia majora too.) This could be done for aesthetic/personal reasons (for example, someone with labial hypertrophy or stretched labia may choose to reduce its size) or due to injury/damage. It may also be chosen to create labia for transfeminine, non-binary, altersex, or intersex people that wished for more neutral/feminine genitals, or alternatively to remove labia for transmasculine, non-binary, altersex, or intersex people that wish for more neutral/masculine genitals.

Labia Stretching: A procedure to stretch out the labia minora, gradually increasing its length. This could be done for aesthetic/personal reasons or for additional sexual enjoyment. It is also explored as a cultural practice by some African communities.

Vulvectomy: A procedure to remove part or all of the outer vulva (labia, hood, clitoris, & hymen.) This could be done for aesthetic/personal reasons or due to injury/damage. It may also be chosen by transmasculine, non-binary, altersex, or intersex people that were unhappy with their vulva.

Infibulation: A procedure to stitch close the vulva, leaving open enough for menstruation and urination (and in some cases, penetration.) In some cases, the labia, clitoris, and/or hood may be removed as well. This could be done for aesthetic/personal reasons, however it is sadly usually done as a form of genital mutilation of AFAB/AXAB minors in some African, Asian, and Middle Eastern cultures.

Hymenotomy: A procedure to open up the hymen of an intersex person that has a imperforate, microperforate, cribriform, septate, or sleeve hymen. This is either done because of menstrual fluids getting trapped inside, to allow for easier penetration, or for aesthetic/personal reasons.

Hymen Reconstruction Surgery/Hymenorrhaphy: A procedure to create or repair a hymen in those with a vagina. This is usually done as a way to fake virginity or "become virgin again", which is influenced by the logical fallacy that hymens break/are stretched during penetrative sex (which is not always the case. They could remain intact, or be stretched by activities like stretching, gymnastics, yoga, horseback riding, etc.) It is sometimes done as a therapeutic procedure for victims of sexual assault/abuse that experienced hymen tearing/stretching during the attack.

Vaginectomy: A procedure to close, tighten, or remove a piece of the vagina. This could be done for aesthetic/personal reasons, due to to injury/damage, or to to block of prolapsing organs. It may also be chosen by transmasculine, non-binary, altersex, or intersex people that were unhappy with their vagina.

Vulvoplasty: A procedure to create or repair a vulva. If this includes the creation or repair of a vaginal entry, it is called a Vaginoplasty. This could be done due to injury/damage, or chosen by transfeminine, non-binary, altersex, or intersex people that were unhappy with their genitals. Labiaplasties and clitoroplasties are often a part of these procedures.

A Phallus-Preserving Vulvoplasty/Phallus-Preserving Vaginoplasty is when a person with a penis chooses to have a vulvoplasty/vaginoplasty, while keeping their penis intact.

Clitoroidectomy: A procedure to remove part or all of the clitoris. This could be due to injury/damage or for aesthetic/personal reasons. It may also be chosen by non-binary, altersex, or intersex people that were unhappy with their clitoris.

Clitoroplasty: A procedure to create or repair a clitoris. This could be due to injury/damage or genital mutilation. It may also be chosen by transfeminine, non-binary, altersex, or intersex people that were unhappy with their small or absent clitoris. For those that had a penis/psuedophallus pre-surgery, either the head or the shaft is used to create/repair the clitoris. For those that lost their clitoris, the recreated clitoris may just be for appearance - it can only be sexually stimulating if the internal clitoral tissue remained sufficiently intact. For those born without any phallus (clitoris, penis, or pseudophallus), the clitoris is created from the labia or scrotum, and is only for appearance.

Metoidioplasty: A procedure to "release" a clitoris enlarged by androgens, by cutting the ligaments that attach it to the pubic bone, allowing it to stand taller when erect, like a typical penis. They can choose to have a scrotoplasty (possibly with prosthetic testes) and/or a urethroplasty (where the urethra is opened on the head of the phallus) if desired. This procedure can be chosen by transmasculine, non-binary, altersex, or intersex people that had a large clitoris.

Phalloplasty: A procedure to create or repair a penis. When done only for the glans, it is known as a Glansplasty. When done only for a scrotum, is is known as a Scrotoplasty. This could be done due to injury/damage, or chosen by transmasculine, non-binary, altersex, or intersex people that were unhappy with their genitals.

For those that had a vulva (or vulva-like genitals) previously, they can choose to have a scrotoplasty (possibly with prosthetic testes) and/or a urethroplasty (where the urethra is opened on the head of the phallus) if desired. If they had a clitoris/phallus previously, the penis is crafted using either some or all of the nerves to induce sexual sensation. If erection is not naturally possible, an implant is placed inside of the penis, in order to activate it manually.

Penectomy: A procedure to remove part or all of a penis. This could be done due to injury/damage or aesthetic/personal reasons. It may also be chosen by transfeminine, non-binary, altersex, or intersex people that were unhappy with their penis.

Genital Nullification: A procedure to remove the genitals, creating a smooth area in its place. Only the urethra (and optionally, sexually stimulating nerves) are left behind. If the sexually stimulating nerves are kept, they can be tactile (buried under the skin, but stimulated through touch) or visual (a lump of nerves, similar to a clitoris.) It may be chosen by transgender, non-binary, altersex, or intersex people that were unhappy with their genitals.

Genital Beading: A procedure to insert beads into the shaft of a penis/phallus or labia. It could be done for aesthetic/personal reasons or for extra sexual stimulation during intercourse (like ribbed condoms/ribbed dildos), almost like "built-in" sex toys. It may also be chosen by altersex or non-binary people that wished for their genitals to have a specific appearance. The beads could be any shape, though they are typically round.

[whencyclopedia]

Menelaus of Alexandria

Menelaus of Alexandria was a Greek astronomer, scientist, and mathematician who lived around 100 CE. Menelaus made a significant and lasting contribution to the fields of astronomy, geometry, and trigonometry. His major work, the Spherics survives and presents what is today called Menelaus' Theorem. The theorem uses lettered diagrams of pure geometry to calculate spherical triangles or distances across a sphere with implications for the practical study of astronomy such as the trajectory of planets. Menelaus, and others like him, reduced the physical world to a purely geometric one, and so he was then able to calculate the unmeasurable, an approach which became the very foundation of modern science.

Life & Works

History is almost totally silent regarding any biographical details of Menelaus. All that we do know is that he made a series of astronomical observations in Rome in 98 CE and that he was known to the Greek writer Plutarch (c. 45-50 CE - c. 120-125 CE). We also know the titles of several of his works, mostly via references in the works of others, notably later Arab writers and compilers of (now mostly lost) ancient texts. These works include:

Spherics (Sphaerica) - Menelaus' most important work, which survives as an Arabic translation. It deals with the mathematical studies of spheres and the implications thereof on the subject of astronomy. The work is divided into three books, the first of which examines spherical triangles, defining them and proposing theorems based on the 4th-3rd century BCE Greek mathematician Euclid's work on plain triangles. This is the earliest surviving detailed study of spherical triangles. The second book concerns spherical topics with observations on astronomy similar to those made by Euclid and the astronomer and mathematician Theodosius of Bithynia (l. c. 100 BCE). The third book is a much more innovative treatise on the fundamental principles of spherical trigonometry, again, the earliest known such study. It presents Menelaus' Theorem (see below) and the Rule of Four Quantities and the Law of Tangents.

Specific Gravities - another surviving work in Arabic translation. This book was dedicated to the Roman emperor Domitian (r. 81-96 CE).

Elements of Geometry - three books mentioned by the Persian scholar al-Biruni (b. 973 CE) and likely a collection of problems concerning Euclidean geometry.

A treatise on chords in a circle, possibly some form of early trigonometric table. This work is referred to by the 4th-century CE mathematician and commentator Theon of Alexandria.

A work on the signs of the zodiac, which is referred to by the 4th-century CE mathematician Pappus of Alexandria.

Three works mentioned in the 10th-century CE Fihrist, an Arabic catalogue by Ibn al-Nadim. These are Book on the Triangle, On the Knowledge of the Weights and the Distribution of Different Bodies, and an untitled work on mechanics. These texts possibly included Menelaus' estimation of the precession of the equinoxes.

Menelaus helped in the progress of science by his reduction of the physical (planets) to the purely geometrical (mathematical diagrams).

Continue reading...